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Kamaruddin Mardhiah,1,2 Nadiah Wan-Arfah,2 Nyi Nyi Naing,3 Muhammad Radzi Abu Hassan,4 Huan-Keat Chan,4 Hazriah Hasan1 1Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia; 2Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia; 3Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia; 4Clinical Research Center, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, MalaysiaCorrespondence: Nadiah Wan-ArfahFaculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, Kuala Terengganu, Terengganu, 21300, MalaysiaTel +6012-6260508Email wanwaj@unisza.edu.myPurpose: This study was conducted to determine the direct medical cost of treating melioidosis patients. The calculation was made according to the variables extracted from medical records.Materials and Methods: Data collection was performed retrospectively on a total of 293 cases from Hospital Sultanah Bahiyah, Kedah, Malaysia. The data consisted of personal information, treatment history, and investigation findings, including blood results, USG abdomen results, and CT scan results. The site of culture and sensitivity were also obtained. The total direct medical cost was based on the antibiotics/treatments received by the patients, diagnostic test and investigations performed. The trend analysis used to see the pattern of costs from 2014 to 2017. All the costs were compared based on patients’ status and duration of stay at the hospital using the independent t-test.Results: The overall mean of direct medical cost for melioidosis amounted to US $233.61 (RM931.33). Overall, the finding confirms a huge reduction (44.7%) of direct medical cost from 2014 to 2017 (P = 0.001). From 2015 to 2016, there was a 19.1% reduction of direct medical cost (P> 0.95), followed by a 38.8% reduction in costs from 2016 to 2017 (P = 0.019). In the case of the duration of stay, the mean of total direct medical cost among patients with ≥ 14 duration of stay was higher compared to those with < 14 duration of stay (p < 0.001). There was no significant mean difference of direct medical cost between patients who were cured and died.Conclusion: Despite the higher mortality of melioidosis cases compared to other infectious diseases, there is a limitation in the amount of published data on the management cost of melioidosis. The importance of cost in managing this disease should be underlined to perform a fully prepared management toward the disease.Keywords: melioidosis, direct medical cost, trend analysis

Nguyen Hoai An Le,1 Hoang Van Phan,1 Jiaqi Yu,2 Hak-Kim Chan,2 Adrian Neild,1 Tuncay Alan1 1Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, VIC, 2The Advanced Drug Delivery Group, Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia Background: This article presents an acoustically enhanced microfluidic mixer to generate highly uniform and ultra-fine nanoparticles, offering significant advantages over conventional liquid antisolvent techniques.Methods: The method employed a 3D microfluidic geometry whereby two different phases – solvent and antisolvent – were introduced at either side of a 1 µm thick resonating membrane, which contained a through-hole. The vibration of the membrane rapidly and efficiently mixed the two phases, at the location of the hole, leading to the formation of nanoparticles.Results: The versatility of the device was demonstrated by synthesizing budesonide (a common asthma drug) with a mean diameter of 135.7 nm and a polydispersity index of 0.044.Conclusion: The method offers a 40-fold reduction in the size of synthesized particles combined with a substantial improvement in uniformity, achieved without the need of stabilizers. Keywords: microfluidics, nanodrugs, budesonide, liquid antisolvent method

Satomi Onoue,1 Shizuo Yamada,1 Hak-Kim Chan2 1Department of Pharmacokinetics and Pharmacodynamics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan; 2Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia Abstract: To date, various nanodrug systems have been developed for different routes of administration, which include dendrimers, nanocrystals, emulsions, liposomes, solid lipid nanoparticles, micelles, and polymeric nanoparticles. Nanodrug systems have been employed to improve the efficacy, safety, physicochemical properties, and pharmacokinetic/pharmacodynamic profile of pharmaceutical substances. In particular, functionalized nanodrug systems can offer enhanced bioavailability of orally taken drugs, prolonged half-life of injected drugs (by reducing immunogenicity), and targeted delivery to specific tissues. Thus, nanodrug systems might lower the frequency of administration while providing maximized pharmacological effects and minimized systemic side effects, possibly leading to better therapeutic compliance and clinical outcomes. In spite of these attractive pharmacokinetic advantages, recent attention has been drawn to the toxic potential of nanodrugs since they often exhibit in vitro and in vivo cytotoxicity, oxidative stress, inflammation, and genotoxicity. A better understanding of the pharmacokinetic and safety characteristics of nanodrugs and the limitations of each delivery option is necessary for the further development of efficacious nanodrugs with high therapeutic potential and a wide safety margin. This review highlights the recent progress in nanodrug system development, with a focus on the pharmacokinetic advantages and safety challenges. Keywords: nanoparticles, nanotechnology, nanotoxicity, solubilization, targeted delivery

© 2015, American Association of Pharmaceutical Scientists. Colistin is often the only effective antibiotic against the respiratory infections caused by multidrug-resistant Gram-negative bacteria. However, colistin-resistant multidrug-resistant isolates have been increasingly reported and combination therapy is preferred to combat resistance. In this study, five combination formulations containing colistin (COL) and rifampicin (RIF) were prepared by spray drying. The lowest minimum inhibitory concentration (MIC) value against Pseudomonas aeruginosa PAO1 was measured for the formulation of COL/RIF = 4:1 with relatively high emitted doses (over 80%) and satisfactory fine particle fractions (over 60%). Data from X-ray photoelectron spectroscopy (XPS) and nano-time-of-flight secondary ion mass spectrometry (ToF-SIMS) showed the surfaces of particles were mainly covered by rifampicin even for the formulation with a mass ratio of COL/RIF = 4:1. Because colistin is hygroscopic and rifampicin is hydrophobic, moisture absorption of combination formulations was significantly lower than the pure colistin formulation in the dynamic vapour sorption results. To investigate the dissolution characteristics, four dissolution test methods (diffusion Franz cell, modified Franz cell, flow-through and beaker methods) were employed and compared. The modified Franz cell method was selected to test the dissolution behaviour of aerosolised powder formulations to eliminate the effect of membrane on dissolution. The results showed that surface enrichment of hydrophobic rifampicin neither affected aerosolisation nor retarded dissolution rate of colistin in the combination formulations. For the first time, advanced surface characterisation techniques of XPS and ToF-SIMS have shown their capability to understand the effect of surface composition on the aerosolisation and dissolution of combination powders.

This chapter discusses various roles of smart information in Supply Chains (SC) of digital age and tries to answer an important question - What types of collaborative arrangements facilitate smart operations to improve planning, production and timely replenishment? We have conducted longitudinal case studies with firms practicing \ud SC collaborations and also using smart information for operations. Based on the case analysis, the companies are further classified as 'smart planning' and 'traditional planning'. Research findings show the importance of aligning SC partnerships based on smart information requirements. These findings are based on case studies of Indian firms with global SC collaboration. We also discuss the role of Big Data for the companies using smart planning.